Facelift | Necklift

San Francisco Facelift and Neck Lift Surgery

Your face is precious and reflects all the challenges, joys, and triumphs you have experienced throughout your life. Despite all the steps you may be taking to age gracefully, some changes are inevitable as you grow older. Various factors affect this process, such as genetics, stress, sun damage, and nutrition. There may come a time when you start seeing undesired changes that no longer match how you feel about yourself. These can be troubling, and you may wish to get plastic surgery to turn back the clock. 

With facelift and neck lift surgery, board-certified plastic surgeon Dr. Ginger Xu can use her expert Ivy League training and surgical skill to reverse some of the most noticeable effects of aging on the face and neck. Though these surgical procedures cannot halt the aging process, they can help you achieve a much more refreshed and youthful appearance. 

Continue reading to learn more about these procedures performed by Dr. Xu, one of the best facelift surgeons in San Francisco. At Ethos Plastic Surgery, our philosophy is to provide unparalleled care with a soft, gentle approach that allows your natural beauty to shine through. 

If you are ready to schedule your confidential consultation at our high-touch boutique practice in the heart of San Francisco, we invite you to contact Dr. Xu online or call (415) 506-4300. She will be happy to answer your questions and help you create the facial plastic surgery plan that best aligns with your needs. We proudly serve patients in and around the Bay Area.

Dr. Xu – Harvard-Trained Facelift Surgeon in San Francisco

Dr. Xu is an Ivy League-trained female plastic surgeon with gifted hands, a sincere devotion to her patients, and an eye for elegant, natural results. Her priority is forming a genuine connection with people to understand what makes them happy.

After a seven-year residency program in plastic surgery at UCSF, Dr. Xu completed an additional year of specialty training through Harvard’s cosmetic surgery fellowship. During this training, she specifically focused on facelifts because she wanted to feel confident in her ability to provide excellent results with her favorite procedure to perform. 

Fellowship training and board certification are two hallmarks of a surgeon’s dedication to the art and science of plastic surgery. They demonstrate a commitment to the highest level of surgical excellence, patient safety, and medical ethics. Harvard only accepts one applicant each year for its rigorous and competitive program.

Dr. Xu believes in the concept of “soft, gentle beauty,” a philosophy that emanates in every aspect of Ethos Plastic Surgery. Our signature aesthetic features a unique blend of sophistication and refinement you will see in every detail. Rest assured that Dr. Xu will do everything she can to make you look younger, rejuvenated, and entirely natural. 

What Is a Facelift?

A facelift is a surgical solution for several typical concerns that emerge with age. When performed by an expert, facelift surgery can rejuvenate your appearance while preserving the unique characteristics that make you look recognizably yourself. 

This facial cosmetic surgery is a safe, effective, and customizable procedure that improves visible signs of aging in the face and neck, such as:

  • Skin laxity or sagging, resulting in a tired or aged look
  • Pronounced nasolabial folds or marionette lines that create the appearance of a permanent frown
  • Loss of youthful volume in the cheek and midface area
  • The appearance of jowls, or drooping facial structures 
before and after facelift necklift female patient front view San Francisco, CA
Real Patient Result

Facelift Surgery Is More Than Skin-Deep

Excellent skin care and non-surgical options can preserve skin quality and overall health, but the effects are merely superficial. Facial aging is not only about wrinkles and fine lines, but also jowling, sagging, tissue descent, loss of youthful volume, bone resorption, elongation of supportive facial structures, etc. 

Regular visits to a qualified dermatologist for rejuvenating treatments like lasers, peels, Botox®, or fillers are one part of the equation. However, the degree of correction you can get with these procedures directly correlates with the degree of invasiveness and intensity of the treatment done. If your goals go beyond just treating the skin, surgical techniques such as a facelift, are the only way to attain the most substantial anti-aging improvements and create a more powerful and long-lasting change.

board-certified plastic surgeon Dr. Ginger Xu

Meet Dr. Ginger Xu

Dr. Xu embraces the responsibility and transformative opportunity to alter a patient’s appearance in a way that is congruent with their own values and matches a more cohesive sense of self; to realign the external with the internal; to create an improved emotional landscape and a better life. These ideals captivate and inspire her every day.

What Can a San Francisco Facelift Do for You?

You may wish to consider facelift surgery if one or more of the following issues are affecting how you feel about yourself.

Skin Laxity, Sagging, and Wrinkles

Over time, your skin gradually loses its structural integrity due to reduced production of collagen and elastin – two proteins that make up your skin’s internal support network. This lack may result in weakening and sagging of your facial skin. During facelift surgery, Dr. Xu will remove excess skin and gently tighten what remains, softening the deep folds around your mouth and creating a smoother, more rejuvenated contour.

Soft Tissue Descent

The skin is not the only component addressed in a facelift. The deeper layers of the face will also begin to descend as the underlying ligaments and supportive structures of the face stretch and weaken over time. As part of the aging process, facial tissues may then shift below the jawline, leading to the appearance of jowls. Successful facelift surgery requires tightening and repositioning the underlying layer, known as the SMAS, to support and lift all the tissues above it. In that way, facelift surgery rebuilds and strengthens the foundation of your face and creates a more youthful, rejuvenated appearance.

Volume Loss

A loss of youthful volume and blunting of facial contours is another change associated with growing older. This may result from fat pads diminishing and shifting downward over time. Additionally, resorption of bone can create a hollowed or gaunt appearance. Targeted fat grafting and resuspending the descended structures in the midface as part of a facelift procedure can restore this lost volume.  

Constant Unhappy or Fatigued Appearance

The effects of aging listed previously can make you look continuously tired, sad, or upset, even if you’re generally a happy and energetic person. Your face may be sending a nonverbal message that does not reflect how you truly feel or what you wish to project to the outside world. This can be disconcerting and painful. Facelift surgery can help better align how you feel with how you look by softening and rejuvenating your facial expressions and bringing a greater sense of harmony.

Low Self-Esteem

Rejuvenating your facial appearance with a natural-looking facelift can profoundly impact your self-confidence. According to multiple academic studies, patients who have undergone plastic surgery with realistic expectations frequently experience enhanced self-esteem after surgery. They report not only looking younger, but also feeling younger and having more positive emotions about themselves in social situations. This surgery can ultimately lead to improved quality of life, both personally and professionally.

Who Is an Ideal Candidate for Facelift Surgery?

Many patients who wish to look younger and more vibrant are well-qualified candidates for facelift procedures. Contrary to what you may have heard, there is no such thing as the “perfect age” to get a facelift; instead, the time is right when your face and neck concerns have advanced to the point that other treatments, such as dermal fillers and similar minimally invasive procedures, no longer provide sufficient improvements.

Dr. Xu will meet with you during a private, in-person consultation to discuss your health history and make sure you do not have any facelift risk factors that could cause complications during surgery or recovery. In general, the best candidates for a Bay Area facelift are nonsmokers who are in good overall physical and mental health, are willing to follow all their recovery instructions, and have a realistic attitude about what this procedure can do for them.

What Happens During a Facelift Procedure?

A facelift is an outpatient surgery that will take place while you are under general anesthesia. Through careful incisions made in discreet locations, Dr. Xu will elevate facial skin and supportive tissues, tighten the supportive structures of the face, resuspend fallen, sagging tissue back to a more youthful position, remove excess skin, and re-drape the remaining skin over the newly repositioned contours. 

When designing your customized surgical plan, Dr. Xu will consider variables such as your goals, age, gender identity, and ethnic heritage and take a natural approach to add more balance and proportion to your facial appearance. In addition to the traditional facelift surgery that you are probably already familiar with, her techniques include the following.

SMAS Facelift

Focusing on the layer of connective tissue underneath the skin and on top of the facial muscles, Dr. Xu will tighten your cheeks, jawline, and neck by working directly on the tissues that provide your face its structural support, rather than relying on a skin-only approach. Also known as the “traditional facelift,” the SMAS facelift offers various benefits, including less of a “pulled” or tight look, greater definition, and natural-looking, long-lasting results. Unlike deep plane facelift, this technique stays above the SMAS and does not elevate it.


Deep Plane Facelift

In a deep plane facelift, Dr. Xu dissects below the SMAS to release some of the retaining structures, which allows greater tissue movement. Operating at this depth creates less skin trauma and a more powerful lift, all while restoring a natural-looking appearance. 

Mini/Short-Scar Facelift

This modified option offers smaller incisions and less cutting of underlying tissue. It is often appropriate for patients with less significant facial aging. Combining this technique with fat grafting can provide a dramatic improvement with a shorter recovery period. 

Facial Fat Grafting

Also known as fat transfer or fat injection, facial fat grafting involves the removal of fat from one area of the body, such as the abdomen or thighs, through the use of liposuction. The harvested fat is then purified and meticulously reinjected into the face, with the aim of restoring volume and fullness to areas that have been affected by the natural process of aging. The cheeks, temples, and under-eye regions are common areas of focus, as they can benefit greatly from the added volume. Fat grafting is safe, effective, and can be seamlessly integrated into a facelift procedure.

What Is Neck Lift Surgery in San Francisco?

Many people notice that their jawline begins losing definition and starts blending into their neck as they get older. In other cases, neck skin can start appearing loose and redundant, with sagging or undesired skin folds and neck bands (also called platysmal bands). These changes can be troubling and adversely impact your self-confidence. A neck lift is a cosmetic procedure that removes and tightens excess skin and sagging structures around your jawline and neck, creating a cleaner and more defined profile. 

before and after facelift necklift female patient right side view San Francisco, CA
Real Patient Result

What Are the Benefits of Neck Lift Surgery?

When performing a neck lift, Dr. Xu will look to resolve multiple concerns simultaneously: 

  • Skin laxity that creates the appearance of jowls 
  • Loose, excess skin folds under the chin and neck      
  • Prominent neck bands and wrinkling
  • Unwanted fat deposits or skin redundancy leading to a double chin
  • Lack of definition between your jawline and neck

A neck lift procedure is worth considering if you are struggling with any or all these issues due to time and gravity.

Who Is an Ideal Candidate for Neck Lift Surgery?

A neck lift and a facelift share similar objectives. The primary difference is that a facelift improves the region between your cheeks and jawline, while a neck lift focuses on the area from your jawline to the base of your neck.     

In most patients, there is some degree of blending between these two zones, and you can see maximal benefit by treating both areas simultaneously. Pairing these procedures creates smoother and tighter skin from the lower two-thirds of your face to your collarbone. This combination can have a much more dramatic impact on your appearance than having either surgery separately, while also saving you money and time. 

Dr. Xu may also suggest adding fat grafting, a brow lift, or eyelid surgery to your customized surgical plan for more comprehensive results.

Combining Facelift and Neck Lift Surgery

Overall, the same characteristics that make you well-qualified for a facelift procedure will also make you a good candidate for neck lift surgery. Additionally, Dr. Xu believes plastic surgery is the right choice for you if it is personally meaningful and can improve your well-being.

Your Facelift and Neck Lift Consultation with Dr. Xu

A plastic surgery consultation is your opportunity to meet Dr. Xu one on one, ask all your questions about your desired procedure, and become a more informed patient. You can think of this private meeting as an interview between you and a potential surgeon to learn if their personality and aesthetic philosophy align with yours. 

During the consultation, Dr. Xu will explain all aspects of the procedure in detail to ensure you understand what it entails and are a good candidate. She will encourage you to ask questions about any aspects you are unsure of.

Come to your consultation prepared to be honest about your health history. If you have specific conditions that can increase your risk of undergoing surgery or anesthesia, Dr. Xu may recommend a different procedure.

Partner With Dr. Ginger Xu, a Leading Female Plastic Surgeon in San Francisco

Dr. Xu firmly believes plastic surgery is an expression of self-love, body positivity, and emphasizing natural results. She can relate to why you may want to have a cosmetic procedure done and advise you on the best ways to reach your desired results.

“In modern culture, we face a unique set of challenges from social messaging about idealized appearances and body types. Sometimes, it’s hard to separate society’s noise from your beliefs and values. I can understand what it’s like to navigate this while also trying to stay true to what you want for your body, on your terms, regardless of what other people think or how it fits into norms. Ultimately, doing what’s right for you is the greatest act of self-care.”

To schedule your facelift and neck lift consultation, reach out to us online or call (415) 506-4300. Dr. Xu will gladly answer all your questions and help you decide if surgery is the right choice for your goals.


Facelift and Neck Lift Bay Area

Your total price will vary based on the details of your unique surgical plan, including whether you choose to combine facelift and neck lift procedures. Dr. Xu’s team will give you a more accurate estimate after meeting with you and learning about your objectives.

We will provide you with detailed instructions to follow, including how to care for your incisions and manage any discomfort, when to schedule follow-up appointments, and when you can return to work and resume your workout regimen.

We recommend planning for at least one to two weeks of downtime after your facelift and neck lift, during which you must avoid strenuous activities, rest when you feel tired, and sleep with your head elevated. It may take several weeks for the post-surgical swelling and bruising to fade fully.

A lower facelift addresses aging in the mid- to lower face. In contrast, a neck lift focuses specifically on tightening loose skin and contouring the region below the jawline and along the neck.

Be prepared to discuss your goals – what areas you would most like to address and what facial aging changes bother you the most. Think about your priorities and also whether you have any particular concerns.  I always find it helpful when patients bring in a younger photo of themselves that they like or find particularly flattering, both as a blueprint for what they hope to restore their appearance to, as well as a way of understanding their individual aesthetics and beauty goals. If inclined, it’s also nice to bring someone with you as a support system and a 2nd pair of eyes and ears. If you have had prior facial surgery, it is helpful to know the details of what you had done and bring prior medical records (operative reports) if possible.

Make sure you have the adequate support you need at home for your recovery. Dr. Xu will review the details of everything you will need to know for this during your Pre Op Appointment. Don’t undertake any major life changes or projects right before or at the time of surgery so you can focus on your recovery. Make sure that you are in a general state of wellness and good health from a physical, mental and emotional standpoint. If you have high blood pressure, this needs to be optimized and normal prior to surgery. No smoking for at least 3 months beforehand. No heavy drinking. Medical issues need to be managed, such as diabetes if present. Do not start any extreme diets or fasting. Make sure you have adequate protein intake before and after surgery. If you are using any topical skin treatments or getting lasers, fillers, or Botox, some of this may need to be stopped prior to surgery. It is very common to be both nervous and excited before surgery. Maintain a positive mindset and try to relax knowing you are in good hands!

This depends on how much you are having done and can range from 3 hours for a mini facelift to 6-8 hours or more for a full face and neck lift with or without the addition of other procedures such as blepharoplasty or facial fat grafting which offers a more comprehensive rejuvenation of the face and even improves skin texture and quality.

There is no typical age, as everyone’s faces change and age in various ways. Some people may see more skin sag and tissue descent in the lower face, whereas others may experience more obvious aging around the cheeks or eyes, or in the neck. There is a wide spectrum when it comes to how faces change with time. For some people who have significant weight loss or genetic propensities for facial aging, they may benefit from a gentle restorative facelift in their 40’s. However, the most common age group typically coming in for a facelift are patients in their 50-60’s. Patients in their 50’s are typically those who are seeing mild to moderate changes and want to “stay on top of things” and get a refresh that is not a dramatic change that would make it apparent that they had surgery. Patients in their 60’s are usually seeing more obvious changes and a facelift would result in a more powerful rejuvenation result, and they have waited to have it done until they really felt it to be necessary. Some people may not be in their 70’s until they feel compelled to seek a facelift, and they are also good candidates so long as they are also in good physical health.

A traditional facelift involves a standard amount of surgical dissection and lifting of the skin which gives the surgeon full access to the underlying facial anatomy in order to re-position and tighten the deeper structures of the face; a facelift typically also extends along the jawline and includes the neck. A mini facelift involves shorter and less-extensive incisions as well as tissue dissection. As a result, the amount of “lift” is also less. A mini-facelift is suitable for someone who has only mild facial aging and does not require the full extent of a facelift surgery; they may benefit from a more minimal approach and only need a smaller amount of tightening focused along the sides of the face.

  • Nothing can come close to offering the powerful and dramatic rejuvenation that a facelift offers. However, there are newer nonsurgical approaches that have continued to be perfected over time. 
  • One tangential way to “lift” the face is by using filler to restore volume where a patient has areas that are sunken and have lost youthful volume; this in turn can “lift the facial skin but only as a subtle secondary effect. It’s also known as a “liquid facelift” but it does not take the place of a surgical facelift. In fact, it can be overdone and patients risk having the face OVER-filled with fillers when this method is relied on too heavily; this may be the case when it is offered and performed by providers who are trained only in fillers and are not able to perform facelifts themselves, thus because they don’t have that skillset and are lacking it in their toolkit of treatment options , they don’t know to offer it to patients and omit correctly transition them to a facelift when it is time. 
  • Another emerging option for a nonsurgical facelift is something called a threadlift, where barbed sutures are placed under the skin and looped along the tissues, then tightened along an arc to suspect the tissues upward; this mimics the “pull” that would be achieved by a facelift, but can be fraught with issues, notably that the results are not permanently but only temporary. In addition, there can be scar tissue formed in the face which makes a future facelift much more challenging and potentially more dangerous.

There is no magic to this and the hands of time will continue turning. A facelift will reset the clock, but it cannot stop the clock. Natural aging will continue, but it is also recommended to optimize the aesthetics of your face by practicing good skin care and protecting your skin from the sun. There are other nonsurgical modalities which can be recommended during a consultation with a skin care specialist that can keep your skin looking vibrant and fresh, which only enhances the results of a facelift. One thing that is very detrimental to skin quality and the aging process is smoking or nicotine intake in any form (patches, gum, e-cigarettes). Nicotine will create a more weathered appearance to your skin and face because it constricts the blood vessels which supply oxygen and nutrients to your skin. In general, avoiding intense sun exposure is also helpful to prevent the formation of wrinkles and lines. There may also be adjunct treatments with Botox that minimize muscle strain in your face and preserve the youthful refresh you get with a facelift; each person’s face will be different in this regard.

You will have swelling and bruising in the 1st week and into the 2nd week. This will fluctuate and how quickly it goes away varies by individual. Typically, most patients are “restaurant ready” by 2 weeks after surgery.

Recovery happens in phases, and depends on the individual’s own genetic capacity for healing as well as underlying risk factors and overall health. In general, you will be most swollen and bruised in the first week and this fades into the second week. Pain is not significant and can be managed with over the counter medications and on occasion require prescription pain meds. You may feel stiff and sore into the 2nd week, but most patients are “restaurant ready” and well enough to return to work after 2 weeks. For patients with a desk job, they can return after 1 week if feeling well. In terms of exercise, you should avoid strenuous activity or any heavy lifting for 4-6 weeks.

You can start gentle exercise at 2 weeks such as walking, but nothing that increases your heart rate too much until 4 weeks, at which time you can start more moderate activities (light weightlifting. No strenuous workouts or intense cardio until 6 weeks after surgery, at which time you will have no activity restrictions.

This depends on what you do for a living. Factors to consider: how intense is the nature of your work, whether you have a desk job or your work requires more physical activity, how public facing your work requires you to be, and your own pace of healing. (see last section to fill this in more, but in general, most people can return to a desk job after 2 weeks, and more active jobs usually 4 weeks.

It would be very high risk to get a facelift in the setting of active smoking. Dr. Xu does not perform facelifts on smokers because smoking or any type of nicotine consumption (patch, gum, e-cigarette) places you at high risk for wound healing problems where your skin may actually  turn black and die, creating a devastating complication and deformity that cannot be fixed. It is best to stop smoking for at least 6 weeks prior to a facelift. However, Dr. Xu may ask that you stop for 3-6 months, as the body tends to still have memory of prior smoking history, and patients with even a prior history of smoking tend to be at a higher risk of wound healing complications. (see some answers above to get into the science more about how nicotine constricts blood vessels, etc.)

The following risks of facelift surgery are uncommon but always possible and include: bleeding or hematoma, infection, wound healing problems, nerve injury, and poor scarring. An individual’s likelihood for experiencing these rare occurrences also correlates with whether they have underlying risk factors such as bleeding disorder, high blood pressure, diabetes, smoking, prior surgery with scarring of tissue planes, and tendency to form hypertrophic scars.

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